Elsevier

Journal of Psychiatric Research

Volume 70, November 2015, Pages 130-136
Journal of Psychiatric Research

Childhood trauma as a risk factor for psychosis: A sib-pair study

https://doi.org/10.1016/j.jpsychires.2015.08.017Get rights and content

Highlights

  • A sib-pair study into patients with recent onset psychotic illness and their non-psychotic siblings was conducted.

  • After controlling for cannabis use and neuroticism, childhood trauma was related to an increased risk of psychosis.

  • Childhood trauma, cannabis use and neuroticism were independently associated with an increased risk of psychosis.

Abstract

Background

Childhood trauma, cannabis use and certain personality traits have been related to the development of psychosis. This study uses a sib-pair design to examine the association between childhood trauma and psychosis controlling for cannabis use and neuroticism.

Methods

We evaluated 60 patient-sibling pairs, conformed by patients with functional psychosis in the first five years of their illness matched with a non-psychotic sibling. In univariate analyses, patients and siblings were compared with McNemar tests and paired-sample t tests. A conditional logistic regression model of the risk of developing psychosis was built. The dependent variable of this model was the patient-sibling status (patient = 1, sibling = 0).

Results

After controlling for cannabis use and neuroticism, the odds of suffering psychosis for subjects who experienced a childhood trauma were 7.3 times higher than the odds for subjects who did not experience a childhood trauma [95% CI, (1.06–50.01); P = 0.04]. Also, after controlling for experiencing childhood trauma and neuroticism, subjects who were heavy cannabis users had odds of suffering psychosis that were 6.4 times higher than the odds of the remaining subjects [95% CI, (1.2–35.2); P = 0.03].

Conclusion

Both childhood trauma and cannabis use were significantly associated with an increased risk of suffering functional psychosis. A neurotic personality also contributed independently to this risk. These findings might help improve the prevention of psychosis and the development of specific treatment strategies on this specific population.

Section snippets

Background

Childhood trauma has been proposed to have a causal role in adult mental health disorders (Spataro et al., 2004), including psychosis. Since the publication of three population studies in 2004 (Bebbington et al., 2004, Janssen et al., 2004, Spataro et al., 2004), an interest in childhood trauma as a risk factor for psychosis development has grown. In two recent meta-analyses (Varese et al., 2012, Matheson et al., 2013), childhood adversity and trauma were found to be associated with an

Participants

This is a 1:1 matched study that included 60 adult patients who were individually paired with a non-psychotic sibling. The patients satisfied the following three inclusion criteria: 1) having a functional psychosis according to DSM-IV psychotic codes 295–298 (American Psychiatric Association, 2000); 2) having less than 5 years of illness; and 3) having a sibling free of psychotic symptoms who was willing to participate in the study. Patients were recruited in the mental health inpatient

Sample characteristics

The diagnoses of the 60 patients whose siblings provided written informed consent and were free of psychotic symptoms were: schizophrenia [58.3% (35/60)]; schizophreniform disorder [1.7% (1/60)]; brief psychotic disorder [15% (9/60)]; schizoaffective disorder [5% (3/60)]; and depressive or manic episode with psychotic features [20% (12/60)].

Comparisons of dichotomous and continuous variables between patients (n = 60) and siblings (n = 60) are described in Table 1, Table 2, respectively.

Discussion

The main result of our study is that both childhood trauma and cannabis use were significantly associated with an increased risk of developing functional psychosis. However, this matched study did not find evidence of a significant synergistic interaction between childhood trauma and cannabis use: these two factors independently increased the risk of developing psychosis in our population. Moreover, a neurotic personality also contributed independently to this risk.

The principal strength of our

Role of funding source

The funding sources did not participate in the collection of data, the interpretation of the results or the writing of the manuscript. They have not taken part in the decision of submitting the manuscript for publication.

This work was partially supported by Grant GI8374199 (Ayudas económicas para el desarrollo de proyectos de investigación sobre drogodependencias 2007, BOE 263, 2 November 2007), BAE 09/90088, Estancia Formativa de la Junta de Andalucia 2010, and grant PI-0211-2007 of

Conflict of interest

None.

Contributors

María L. Barrigón participated in the design of the study, the collection of data, the interpretation of the data and the drafting the article; she approved the final version of the manuscript. Francisco J. Diaz conducted the statistical analyses and participated in the interpretation of the data and the drafting the article; he approved the final version of the manuscript. Manuel Gurpegui participated in the design of the study, the interpretation of the data and in drafting the article; he

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